Friends help injured cyclist without health insurance to race again in Ironman World Championship

Mark Hoffman, 35, got in a bike wreck this past May and suffered injuries to the tune of tens of thousands of dollars. He didn't have health insurance -- despite engaging in a risky hobby -- but the cycling and triathlon communities rallied around

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Mark Hoffman, 35, got in a bike wreck this past May and suffered injuries to the tune of tens of thousands of dollars. He didn't have health insurance -- despite engaging in a risky hobby -- but the cycling and triathlon communities rallied around

He gambled by not getting health insurance, then crashed his bike. Did he get what he deserved?

Though he didn’t have health insurance when he broke three vertebrae and two ribs in a bike crash in May, the 35-year-old Charlotte man was lifted up by a network of friends and fellow cyclists that mobilized in speed and spectacular fashion: While he lay in his hospital bed, unbeknownst to him, $17,000 was raised to put toward his medical bills within a period of roughly 24 hours.

Then in the months that followed Hoffman pushed through a remarkable recovery that on Saturday morning will put him, against many odds, at the starting line of what many consider to be the world’s most famous one-day endurance event, the Ironman World Championship in Kona, Hawaii.

But this story is much more complicated than that, and he knows it.

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Hoffman – the owner of Inside Out Sports, a small triathlon store on the edge of uptown – knows very well that you might frown on his decision to blow through a stop sign on his bike at a high rate of speed, which contributed to his crash.

He knows that almost certainly you will wonder why he’d regularly climb onto a bike and take it out on public roads in the first place, if he wasn’t covered by a health insurance plan.

And while he knows that these issues make his otherwise-inspiring story a little less straightforward, he also wants you to know that although they may seem like irresponsible decisions, there’s much more thought that went into making them than perhaps meets the eye.

The accident

Carrying on a decades-long tradition, a large group of cyclists met in a northeast Charlotte industrial area (at General Commerce Drive and Industrial Center Circle) on the evening of Tuesday, May 30, to participate in a ride that sees them continuously covering a loop of roughly two-thirds of a mile.

Hoffman says he had joined four times previously that spring and – like many in the group – used it as a “fast, hard training ride,” also describing it as a workout in which “it’s like all or nothing for about an hour.” The fastest and most experienced cyclists also navigated the course in tight packs.

Shortly before the end of the ride, Hoffman’s group ignored (as it always does) a posted stop sign in making a 90-degree semi-blind right turn at about 25-30 miles per hour, only to find a tractor-trailer coming at them from the opposite direction.

One of the cyclists that lost control went down directly in front of Hoffman, who struck the other cyclist and was thrown from his bike head-first into the side of the truck and sent sprawling to the pavement. (Two other cyclists were treated for minor injuries.)

“When I came to a stop ... there was just this excruciating pain in my back, beyond normal impact pain,” recalls Hoffman, who in addition to the broken vertebrae and ribs had a gash on his head that would require 10 staples. “Very quickly, one of the first thoughts that I had when I was on the ground was, ‘Man, I hope this isn’t too serious, because I don’t have that (financial) net beneath me.’”

The response

Because so many people had witnessed it (he estimates 50 cyclists were at the ride that evening), word of Hoffman’s accident quickly spread through social media. Friends milled around the waiting room, friends stayed through the night taking turns making sure he was comfortable in his hospital bed, his parents drove six hours through the night from Virginia to help lend love and support.

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There was good news the next morning: An MRI confirmed he had not suffered spinal ligament damage, meaning that 1) his body would almost certainly eventually heal on its own and 2) he would not need surgery.

Mark Hoffman at Carolinas Medical Center in Charlotte, where he was treated for three broken vertebrae, two broken ribs and a large gash on his head.

Courtesy of Mark Hoffman

But another grim reality was setting in, and it was pulled into sharp focus when a hospital representative walked into Hoffman’s room to ask for health insurance information.

“It becomes more real when you verbalize anything,” he says. “How often do we have a thought that goes through our head, or a situation that happens, you just think, ‘OK, let’s just not acknowledge it and it won’t be as real’? ... Anyway, at that time, I happened to have two of my best friends in the room with me, and I had to really swallow a lump in my throat.”

Three days after the crash, Hoffman was discharged from the hospital and returned to his apartment to find flowers on the table, food in the freezer, and a beaming roommate who was eager to tell him the news about the charitable windfall.

“He showed me his phone and ... I just remember staring at it and thinking, ‘The comma’s in the wrong spot,’ or ‘There must be a misunderstanding,’” he recalls. “I looked at him, and he looked at me, and I looked at the phone, I looked at him. And I got pretty choked up.”

His medicals bills would eventually climb to north of $35,000. Though he hadn’t asked for a penny, the GoFundMe eventually generated $21,355.

The stop sign

Here’s one of the main things, of course, that will complicate the issue for a lot of people: Couldn’t this all have been avoided if Hoffman and the other cyclists hadn’t ignored the stop sign in the business park to begin with?

And the easy answer is yes.

Hoffman acknowledges the dangers of running through a stop sign at high speed on a public road, but says precautions were taken to mitigate the risk.

For starters, the ride didn’t start till after 6 p.m., in a business park that sees very little thru traffic in the evening. Signs were posted near the entrance of the business park to indicate that a ride was in progress, and dozens of orange cones were set out along the route to keep oncoming traffic from their lane, including on the street the tractor-trailer was driving.

In the ride’s 23-year history, Hoffman says, there previously hadn’t been any major incidents of record. Over the course of his five times participating, he says he recalls seeing just a few cars on the streets they were using.

Now, this doesn’t excuse the cyclists’ actions, but the Charlotte Mecklenburg Police Department says they did a full investigation of the accident before deciding to file no charges and issuing no citations.

However, police did warn them that they did not have permission to be racing on city streets.

“Every single cyclist who participated in that ride accepted that change was necessary in the aftermath of what happened,” Hoffman says.

First responders tend to Mark Hoffman after he crashed into a tractor-trailer during a group cycling ride in northeast Charlotte on May 30.

Courtesy of Mark Hoffman

The ride, in its traditional form, has ceased since that Tuesday. Organizers would like to see it return, but not until permits can be obtained to close down those roads, volunteers can be recruited to man intersections, and insurance can be secured to protect riders.

“Sometimes you need a situation like this in order to recognize when change is necessary,” Hoffman says. “If I had the opportunity to go back ... I would make a different decision.”

The lack of insurance

Same goes for his decision to be without health insurance.

And frankly, if anyone should know better than to not have coverage, it’s Mark Hoffman.

The son of a general surgeon and a nurse, Hoffman earned degrees in math and economics from Emory University in Atlanta and started his professional life as a financial advisor who stressed to clients the importance of – among other things – having adequate insurance in the event of unforeseen medical issues.

But in 2011, he quit his corporate job and gave up his cushy benefits; then in 2012, he took a job fixing bikes and selling running shoes at a Charlotte triathlon store called TrySports, having come to the conclusion that “making money and fulfilling somebody else’s idea of what constitutes a successful career” was not at the top of his to-do list.

As he bounced from TrySports to Uptown Cycles to Inside Out Sports, Hoffman did what he could to make sure he had healthcare insurance. At TrySports, he paid for and received coverage under the Affordable Care Act; at Uptown, his employer split the cost of the policy 50-50; Inside Out had a group plan.

There are also gaps in there when he had no coverage at all.

But otherwise, he didn’t think much of it. In the five years leading up to the accident this past May, Hoffman says he had been to see a doctor exactly zero times. No ER or urgent-care visits, no physical exams, no prescription drugs – nothing.

However, at the time of the accident – which occurred 25 days after he opened his new store – he had not yet gotten around to enrolling.

Hoffman won’t make excuses for his decision, but he also doesn’t think it’s as clear-cut as others might.

For one, as a guy who might be lucky to make $25,000-$30,000 in a year as he tries to establish his business, the ACA premium he’s been quoted – $451 per month ($5,412 per year) – is no small expense.

He also expresses frustration with the current system, while acknowledging how those complaints will sound: “To say that there exists a better system is not a viable excuse.”

Yet his thoughts come out like an avalanche:

“I think that young and healthy people face a difficult decision. If we have access to a large group health insurance plan, our decision is very easy. For a reasonable cost, we can have close to the expected cost of care delivered to us, as well as catastrophic coverage. But I’m not in that situation.

“So I made a very difficult decision – based on the cost and the expected benefit – to take the riskier avenue, which involved not having health insurance.

“Ultimately, the benefits associated with being on a bike and living a healthy lifestyle outside of not having insurance, I believe those outweigh the risk associated with not having it, in the sense that I’m better off riding my bike and taking that risk than not being physically active or not being healthy. Certainly riding a bike is not the only way to be healthy, but if there existed a more middle-of-the-road avenue in which a reasonable premium would cover my catastrophic needs, I would have gladly taken it. And I think that most people my age and with my health care needs would agree with me. I would love one day for that avenue to exist. But at the time that I made the decision, I didn’t believe that the expected cost would warrant the expected benefit.”

The rest of the story

At this moment, Mark Hoffman is in Hawaii preparing for Saturday’s Ironman World Championships, a grueling event in which competitors must swim 2.4 miles, bike 112 miles and run 26.2 miles while battling insane winds and unbearable heat.

(That is, by any measure, remarkable – to go from three broken vertebrae to eight weeks in a back brace to there, in less than five months.)

As for anyone thinking, Wait, Hawaii? How did he afford that? He says airfare and hotel accommodations were booked before the accident happened, paid for collectively by himself, his family and a close friend who offered to sponsor him for the year. Not a single penny from the donations to his medical fund will be used to finance the trip.

And generally speaking, he’s incredibly frugal. He drives a 2000 Toyota Avalon that once belonged to his mother. He shares a condo with a roommate so that he can keep his housing costs under $700 per month. He hasn’t taken a vacation of any significance since 2010.

Sure, some might look askance at his fancy, expensive race bike and money he spends with an eye toward making him or it faster, but he says – as the owner of a triathlon store – “it behooves my professional success to practice what I preach.”

A collection of thank-you cards prepared by Mark Hoffman for people who made donations to the GoFundMe campaign set up by friends after his accident.

Courtesy of Mark Hoffman

He also understands that substantial sacrifices will be necessary moving forward. Though close to 60 percent of his medical costs will be covered by the GoFundMe campaign, there’s still a $14,000-plus bill coming his way. He’s applying for financial assistance from the hospital, but it’s a slow process, and there are no guarantees.

So his focus, for now, is on letting the people who came to his aid know how grateful he is. In fact, he thinks that that’s exactly what this Saturday’s race is all about.

“I have this sense of responsibility ... to try to be respectful of those contributions,” says Hoffman, who qualified for the event by finishing second out of 184 athletes in his age group at an Ironman event in Chattanooga, Tenn., in 2016. “That’s one of the reasons I’m excited about, is that I perceive this as an opportunity to show people I’ve done everything I can, this is how much it means to me that you’ve all helped to make my life better in the most vulnerable situation of my 35 years. ...

“And I know it’s a bit silly to think that, OK, I’m gonna swim and I’m gonna bike and I’m gonna run? That’s my contribution? I mean, come on. It doesn’t warrant $21,000. But if I can show people in more than just words, but through actions – I’m healthy again, I’m really happy, I’m fulfilling a life dream – that’s the respect I think their contribution commands.”